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Review
. 2023 Nov 1;8(11):830-840.
doi: 10.1530/EOR-23-0101.

Primary total knee arthroplasty in hemophilic arthropathy

Gautier Beckers  1   2 , Vincent Massé  1   2   3 , Pascal-André Vendittoli  1   2   3 , Mina W Morcos  1   2
Affiliations
Review

Primary total knee arthroplasty in hemophilic arthropathy

Gautier Beckers et al. EFORT Open Rev. .

Abstract

Advanced hemophilic knee arthropathy is a frequent and devastating manifestation of severe hemophilia with significant implications for activities of daily living. Hemophilic arthropathy is caused by repeated bleeding, resulting in joint degeneration, pain, deformity and disability. In patients with hemophilia and advanced disease, total knee arthroplasty (TKA) has proven to be the most successful intervention, improves physical function and reduces knee pain. Hemophilic patients carry additional risks for complications and required specific pre/postoperative considerations. Expert treatment center should be used to improve patient outcome. Hemophilic patients present significant surgical challenges such as joint destruction, bone loss, severe ankylosis and oligoarticular involvement. The surgeon performing the arthroplasty must be experienced to manage such problems.

Keywords: complications; hemophilia; hemophilic arthropathy; knee; outcomes; total knee arthroplasty.

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Conflict of interest statement

The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research reported.

Figures

Figure 1
Figure 1
Anteroposterior (A), lateral (B) and axial patellofemoral (C) radiographs of both knees in a 36-year-old male with severe hemophilia A.
Figure 2
Figure 2
Example of long leg radiographs of two hemophilic patients with HA and severe musculoskeletal deformities.
Figure 3
Figure 3
Anteroposterior, lateral and axial patellofemoral radiographs of a right knee (A: preoperative, B: postoperative). Forty-nine-year-old patient with severe hemophilia A who had a cemented total knee arthroplasty with patellar resurfacing for end-stage knee hemophilic arthropathy. At 5 years of follow-up, the patient is free of pain and satisfied with the surgery. He has a range of motion of 0–90 degrees.
Figure 4
Figure 4
Anteroposterior, lateral and axial patellofemoral radiograph of a right knee (A: preoperative, B: postoperative). The patient is a 55-year-old male with severe type A hemophilia.
See this image and copyright information in PMC

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